Individual
CHERYL ANN TANASOVICH
Active
Individual
CHERYL ANN TANASOVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
Primary
G53455
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004133440
AETNA PROVIDER NUMBER
CA
01
—
00G534550
BLUE SHIELD PROV #
CA
01
—
00G534551
MEDI-CAL PROVIDER NUMBER
CA
01
—
070003525
RAILROAD MEDICARE PROV #
CA
01
—
931041613
TRICARE PROVIDER NUMBER
CA
Enumeration date
07/08/2006
Last updated
07/18/2007
Update your record
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